§ 26-34-118 — Regulation of health maintenance organization producers

Wyoming § 26-34-118

• Jurisdiction: Wyoming
• Title 26: Insurance Code
• Ch. 34: HEALTH MAINTENANCE ORGANIZATIONS

Text

(a) The commissioner, after notice and hearing, may
promulgate reasonable rules and regulations as necessary to
provide for the licensing of health maintenance organization
producers. The rules shall establish:
(i) The requirements for licensure of resident health
maintenance organization producers;
(ii) The conditions for entering into reciprocal
agreements with other jurisdictions for the licensure of
nonresident health maintenance organization producers;
(iii) Any examination, prelicensing or continuing
education requirements;
(iv) The requirements for registering and terminating
the appointment of health maintenance organization producers;
(v) Any requirements for registering any assumed
names or office locations in which a health maintenance
organization producer does business;
(vi) The conditions for health maintenance
organization producer license renewal;
(vii) The grounds for denial, refusal, suspension or
revocation of a health maintenance organization producer's
license;
(viii) Any required fees for the licensing activities
of health maintenance organization producers; and
(ix) Any other requirement or procedure and any form
reasonably necessary to provide for the effective administration
of the licensing of health maintenance organization producers
under this section.
(b) None of the following shall be required to hold a
health maintenance organization producer license:
(i) Any regular salaried officer or employee of a
health maintenance organization who devotes substantially all of
his time to activities other than the taking or transmitting of
applications or membership fees or premiums for health
maintenance organization membership, or who receives no
commission or other compensation directly dependent upon the
business obtained and who does not solicit or accept from the
public applications for health maintenance organization
membership;
(ii) Employers or their officers or employees or the
trustees of any employee benefit plan to the extent that the
employers, officers, employees or trustees are engaged in the
administration or operation of any program of employee benefits
involving the use of health maintenance organization
memberships, provided that the employers, officers, employees or
trustees are not in any manner compensated directly or
indirectly by the health maintenance organization issuing the
health maintenance organization memberships;
(iii) Banks or their officers and employees to the
extent that the banks, officers and employees collect and remit
premiums by charging the same against accounts of depositors on
the orders of the depositors; or
(iv) Any person or the employee of any person who has
contracted to provide administrative, management or health care
services to a health maintenance organization and who is
compensated for those services by the payment of an amount
calculated as a percentage of the revenues, net income or profit
of the health maintenance organization, if that method of
compensation is the sole basis for subjecting that person or the
employee of the person to this act.
(c) The commissioner, by rule, may exempt certain classes
of persons from the requirement of obtaining a license if:
(i) The functions they perform do not require special
competence, trustworthiness or the regulatory surveillance made
possible by licensing; or
(ii) Other existing safeguards make regulation
unnecessary.